Research On The Construction And Application Of "Kangaroo Mother Care" Clinical Nursing Pathway In Preterm Infants

ObjectiveTo establish a clinical nursing pathway which is suitable for kangaroo mother care in preterm infants in our country,explore the application effects of the established clinical nursing pathway in preterm infants,and provide reference and guidance for the further promotion of kangaroo mother care in our country.Methods(1)Convenience sampling method was used to extract 100 cases of children who implement KMC from January 2018 to October 2019.The index nodes and time nodes were determined through regression analysis of cases,and the frequency of use of nursing items in the case data was counted.According to the Pareto principle,the nursing items were determined,and then through literature review,the unstandardized descriptions in the text were modified accordingly to form the first draft of the clinical nursing pathway.Based on the preliminary draft of the clinical nursing pathway,the questionnaire was formed,and then the Delphi method was used to conduct two rounds of correspondence inquiries to 10experts from the medical or nursing field to formulate the final clinical nursing pathway form of"kangaroo mother care"finally.(2)Using the convenience sampling method,64 preterm infants who were hospitalized in the neonatology department of a tertiary A hospitals in Hunan Province from May 2020 to July 2020 were chosen for the research objects,and they were stochastically separated into the intervention and control groups.There were 32 preterm infants in each group.Because of the outflow of 2 cases in the control group and the intervention group during the intervention process,30 cases in each of the two groups were finally included in the statistics.The preterm infants in the control group were treated with kangaroo mother care according to the hospital’s routine methods,and the preterm infants in the intervention group were handled with kangaroo mother care according to the constructed clinical nursing pathway.The general information of the two groups of preterm infants and their families,the length of hospital stay,the cost of hospitalization,the number of complications types that occurred in premature infants during the hospitalization,and the total result of family satisfaction were contrasted and analyzed.(3)The data input and analysis were developed by SPSS 22.0statistical software package.Descriptive statistics were performed using mean,percentage,and standard deviation.Analyze the response rate of questionnaires,the coefficient of familiarity with experts of correspondence,the coefficient of judgment,and the coefficient of authority,and the Kendall correlation analysis method is used to analyze the coordination coefficient of each node of the two rounds of correspondence.The t test andχ~2 test were used to statistically analyze the length of hospitalization,hospitalization expenses and other related evaluation indicators.Results(1)The positive coefficients of the two rounds of experts were both100%,the average values of the familiarity coefficient and judgment coefficient of the experts were 0.860 and 0.940 respectively,and the authority coefficient of the experts was 0.900.In the first round of correspondence,the coefficients of variation of time nodes,item nodes and nursing items were 0.020,0.015 and 0.084 respectively,and the coordination coefficients were 0.300,0.300 and 0.253 respectively.In the second round of correspondence,the coefficients of variation of time nodes,item nodes and nursing items were 0.035,0.024 and 0.070 respectively,and the coordination coefficients were 0.333,0.225 and 0.318 respectively.(2)The constructed clinical nursing pathway includes 6 time nodes:the first day of admission,the day before first day of KMC;the first day of KMC,the second day of KMC to 1-2 days before discharge,the day of discharge,and after discharge.A total of nine index nodes,including nursing assessment,admission education,discharge education,health education,evaluation,and nursing,followed up,variation column and signature column and 61 specific content items were also contained in the clinical nursing pathway.(3)Evaluation of the application effect of"kangaroo mother care"clinical nursing pathway:(1)Comparing the general data of the two groups of children and their families,there was no statistically significant difference between the two groups of children in terms of gestational age,weight,gender,Apgar score,and the child’s current medical insurance form.The two groups of children’s family members were not statistically different in age,gender,There are no statistically significant differences in education,marital status,occupation,place of residence,and per capita monthly income,and they are comparable;(2)Comparing the length of stay in hospital of preterm infants in two groups,the length of stay in the intervention group(35.73±14.07)was lesser than that of the control group(44.20±16.02)(P<0.05),the disparity was statistically significant;(3)Comparing the hospitalization expenses of the preterm infants in two groups,the hospitalization expenses of the preterm infants in the intervention group(38351.06±15740.09)yuan were lower than those of the control group(49723.43±21200.98)yuan(P<0.05),the disparity in two groups was obviously statistically significant;(4)Comparing the satisfaction scores of the families of the preterm infants in two groups,the satisfaction scores of the family members of the preterm infants in the intervention group(42.13±2.96)were superior than the scores in the control group(32.50±4.02)(P<0.05),and the disparity was statistically significant;(5)Compare the numbers of complications types in the two groups of preterm infants.The numbers of complications types in the intervention group(2.67±0.66)were lesser than the numbers in the control group(2.97±0.85)(P>0.05),and the disparity was not statistically significant.(6)Comparing the scores of HADS of the families in two groups of children before the intervention,the difference was not statistically significant and comparable;after the intervention,the scores of HADS of the families in the two groups of children were reduced,and the scores of the families of the children in the intervention group decreased more than those in the control group.Compared with the scores of anxiety and depression of children’s families,the difference was statistically significant(P<0.05).Conclusion(1)Through retrospective analysis of cases,literature review and Delphi expert inquiry method,it is possible to construct a"kangaroo care"clinical nursing pathway which is suitable for use in preterm infants;(2)The"kangaroo mother care"clinical nursing pathway constructed by this research can effectively shorten the hospitalization time of preterm infants,reduce the cost of hospitalization,improve the satisfaction of the preterm infants’families with the quality of medical work and alleviate the anxious and depress of family members of preterm infants.